Surgical instrument with multi-function button

ABSTRACT

An ultrasonic instrument includes a body, an actuation assembly, a shaft assembly, and an end effector. The actuation assembly includes an activation member that is operable to move in a first direction to select a mode of operation. The shaft assembly extends distally from the body and includes an acoustic waveguide. The end effector includes an ultrasonic blade that is in acoustic communication with the acoustic waveguide. The activation member is operable to move in a second direction to activate the end effector in a mode of operation selected by movement of the activation member in the first direction.

BACKGROUND

A variety of surgical instruments include an end effector having a bladeelement that vibrates at ultrasonic frequencies to cut and/or sealtissue (e.g., by denaturing proteins in tissue cells). These instrumentsinclude one or more piezoelectric elements that convert electrical powerinto ultrasonic vibrations, which are communicated along an acousticwaveguide to the blade element. The precision of cutting and coagulationmay be controlled by the operator's technique and adjusting the powerlevel, blade edge angle, tissue traction, and blade pressure.

Examples of ultrasonic surgical instruments include the HARMONIC ACE®Ultrasonic Shears, the HARMONIC WAVE® Ultrasonic Shears, the HARMONICFOCUS® Ultrasonic Shears, and the HARMONIC SYNERGY® Ultrasonic Blades,all by Ethicon Endo-Surgery, Inc. of Cincinnati, Ohio. Further examplesof such devices and related concepts are disclosed in U.S. Pat. No.5,322,055, entitled “Clamp Coagulator/Cutting System for UltrasonicSurgical Instruments,” issued Jun. 21, 1994, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 5,873,873, entitled“Ultrasonic Clamp Coagulator Apparatus Having Improved Clamp Mechanism,”issued Feb. 23, 1999, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 5,980,510, entitled “Ultrasonic ClampCoagulator Apparatus Having Improved Clamp Arm Pivot Mount,” issued Nov.9, 1999, the disclosure of which is incorporated by reference herein;U.S. Pat. No. 6,283,981, entitled “Method of Balancing AsymmetricUltrasonic Surgical Blades,” issued Sep. 4, 2001, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 6,309,400,entitled “Curved Ultrasonic Blade having a Trapezoidal Cross Section,”issued Oct. 30, 2001, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 6,325,811, entitled “Blades withFunctional Balance Asymmetries for use with Ultrasonic SurgicalInstruments,” issued Dec. 4, 2001, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 6,423,082, entitled“Ultrasonic Surgical Blade with Improved Cutting and CoagulationFeatures,” issued Jul. 23, 2002, the disclosure of which is incorporatedby reference herein; U.S. Pat. No. 6,773,444, entitled “Blades withFunctional Balance Asymmetries for Use with Ultrasonic SurgicalInstruments,” issued Aug. 10, 2004, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 6,783,524, entitled“Robotic Surgical Tool with Ultrasound Cauterizing and CuttingInstrument,” issued Aug. 31, 2004, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 8,057,498, entitled“Ultrasonic Surgical Instrument Blades,” issued Nov. 15, 2011, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.8,461,744, entitled “Rotating Transducer Mount for Ultrasonic SurgicalInstruments,” issued Jun. 11, 2013, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 8,591,536, entitled“Ultrasonic Surgical Instrument Blades,” issued Nov. 26, 2013, thedisclosure of which is incorporated by reference herein; and U.S. Pat.No. 8,623,027, entitled “Ergonomic Surgical Instruments,” issued Jan. 7,2014, the disclosure of which is incorporated by reference herein.

Still further examples of ultrasonic surgical instruments are disclosedin U.S. Pub. No. 2006/0079874, entitled “Tissue Pad for Use with anUltrasonic Surgical Instrument,” published Apr. 13, 2006, the disclosureof which is incorporated by reference herein; U.S. Pub. No.2007/0191713, entitled “Ultrasonic Device for Cutting and Coagulating,”published Aug. 16, 2007, the disclosure of which is incorporated byreference herein; U.S. Pub. No. 2007/0282333, entitled “UltrasonicWaveguide and Blade,” published Dec. 6, 2007, the disclosure of which isincorporated by reference herein; U.S. Pub. No. 2008/0200940, entitled“Ultrasonic Device for Cutting and Coagulating,” published Aug. 21,2008, the disclosure of which is incorporated by reference herein; U.S.Pub. No. 2008/0234710, entitled “Ultrasonic Surgical Instruments,”published Sep. 25, 2008, the disclosure of which is incorporated byreference herein; and U.S. Pub. No. 2010/0069940, entitled “UltrasonicDevice for Fingertip Control,” published Mar. 18, 2010, the disclosureof which is incorporated by reference herein.

Some ultrasonic surgical instruments may include a cordless transducersuch as that disclosed in U.S. Pub. No. 2012/0112687, entitled “RechargeSystem for Medical Devices,” published May 10, 2012, the disclosure ofwhich is incorporated by reference herein; U.S. Pub. No. 2012/0116265,entitled “Surgical Instrument with Charging Devices,” published May 10,2012, the disclosure of which is incorporated by reference herein;and/or U.S. Pat. App. No. 61/410,603, filed Nov. 5, 2010, entitled“Energy-Based Surgical Instruments,” the disclosure of which isincorporated by reference herein.

Additionally, some ultrasonic surgical instruments may include anarticulating shaft section. Examples of such ultrasonic surgicalinstruments are disclosed in U.S. Pub. No. 2014/0005701, published Jan.2, 2014, entitled “Surgical Instruments with Articulating Shafts,” thedisclosure of which is incorporated by reference herein; and U.S. Pub.No. 2014/0114334, published Apr. 24, 2014, entitled “Flexible HarmonicWaveguides/Blades for Surgical Instruments,” the disclosure of which isincorporated by reference herein.

While several surgical instruments and systems have been made and used,it is believed that no one prior to the inventors has made or used theinvention described in the appended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

While the specification concludes with claims which particularly pointout and distinctly claim this technology, it is believed this technologywill be better understood from the following description of certainexamples taken in conjunction with the accompanying drawings, in whichlike reference numerals identify the same elements and in which:

FIG. 1 depicts a block schematic view of an exemplary surgicalinstrument;

FIG. 2 depicts a side elevational view of another exemplary surgicalinstrument, including a sensor;

FIG. 3 depicts a perspective view of another exemplary surgicalinstrument including an exemplary alternative activation button;

FIG. 4A depicts a top schematic view of the activation button of thesurgical instrument of FIG. 3, showing the activation button in a firstposition;

FIG. 4B depicts a top schematic view of the activation button of thesurgical instrument of FIG. 3, showing the activation button in a secondposition;

FIG. 4C depicts a top schematic view of the activation button of thesurgical instrument of FIG. 3, showing the activation button in a thirdposition;

FIG. 5 depicts a side elevational view of another exemplary surgicalinstrument, including another exemplary alternative activation button;

FIG. 6 depicts a perspective view of the surgical instrument of FIG. 5,showing a power display feature;

FIG. 7 depicts a side elevational view of another exemplary surgicalinstrument, including another exemplary alternative activation button;

FIG. 8 depicts a graph showing a plot of button displacement versuspower associated with the surgical instrument of FIG. 7;

FIG. 9 depicts a front elevational view of another exemplary surgicalinstrument, including another exemplary alternative activation button;

FIG. 10 depicts a front elevational view of one exemplary switch layoutthat may be associated with the activation button if FIG. 9;

FIG. 11 depicts a front elevational view of another exemplary switchlayout that may be associated with the activation button if FIG. 9;

FIG. 12 depicts a front elevational view of another exemplary switchlayout that may be associated with the activation button if FIG. 9;

FIG. 13 depicts a perspective view of another exemplary surgicalinstrument, including another exemplary alternative activation button.

FIG. 14A depicts a cross-sectional side view of the activation button ofFIG. 12, showing the button in a non-activating state;

FIG. 14B depicts a cross-sectional side view of the activation button ofFIG. 12, showing the button in a first activating state; and

FIG. 14C depicts a cross-sectional side view of the activation button ofFIG. 12, showing the button in a second activating state.

The drawings are not intended to be limiting in any way, and it iscontemplated that various embodiments of the technology may be carriedout in a variety of other ways, including those not necessarily depictedin the drawings. The accompanying drawings incorporated in and forming apart of the specification illustrate several aspects of the presenttechnology, and together with the description serve to explain theprinciples of the technology; it being understood, however, that thistechnology is not limited to the precise arrangements shown.

DETAILED DESCRIPTION

The following description of certain examples of the technology shouldnot be used to limit its scope. Other examples, features, aspects,embodiments, and advantages of the technology will become apparent tothose skilled in the art from the following description, which is by wayof illustration, one of the best modes contemplated for carrying out thetechnology. As will be realized, the technology described herein iscapable of other different and obvious aspects, all without departingfrom the technology. Accordingly, the drawings and descriptions shouldbe regarded as illustrative in nature and not restrictive.

It is further understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Thefollowing-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

For clarity of disclosure, the terms “proximal” and “distal” are definedherein relative to an operator or other operator grasping a surgicalinstrument having a distal surgical end effector. The term “proximal”refers to the position of an element closer to the operator or otheroperator and the term “distal” refers to the position of an elementcloser to the surgical end effector of the surgical instrument andfurther away from the operator or other operator.

I. Overview of Exemplary Ultrasonic Surgical System

FIG. 1 shows components of an exemplary surgical system (10) indiagrammatic block form. As shown, system (10) comprises an ultrasonicgenerator (12) and an ultrasonic surgical instrument (20). As will bedescribed in greater detail below, instrument (20) is operable to cuttissue and seal or weld tissue (e.g., a blood vessel, etc.)substantially simultaneously, using ultrasonic vibrational energy.Generator (12) and instrument (20) are coupled together via cable (14).Cable (14) may comprise a plurality of wires; and may provideunidirectional electrical communication from generator (12) toinstrument (20) and/or bidirectional electrical communication betweengenerator (12) and instrument (20). By way of example only, cable (14)may comprise a “hot” wire for electrical power to surgical instrument(20), a ground wire, and a signal wire for transmitting signals fromsurgical instrument (20) to ultrasonic generator (12), with a shieldsurrounding the three wires. In some versions, separate “hot” wires areused for separate activation voltages (e.g., one “hot” wire for a firstactivation voltage and another “hot” wire for a second activationvoltage, or a variable voltage between the wires proportional to thepower requested, etc.). Of course, any other suitable number orconfiguration of wires may be used. It should also be understood thatsome versions of system (10) may incorporate generator (12) intoinstrument (20), such that cable (14) may simply be omitted.

By way of example only, generator (12) may comprise the GEN04, GEN11, orGEN 300 sold by Ethicon Endo-Surgery, Inc. of Cincinnati, Ohio. Inaddition or in the alternative, generator (12) may be constructed inaccordance with at least some of the teachings of U.S. Pub. No.2011/0087212, entitled “Surgical Generator for Ultrasonic andElectrosurgical Devices,” published Apr. 14, 2011, the disclosure ofwhich is incorporated by reference herein. Alternatively, any othersuitable generator (12) may be used. As will be described in greaterdetail below, generator (12) is operable to provide power to instrument(20) to perform ultrasonic surgical procedures.

Instrument (20) comprises a handpiece (22), which is configured to begrasped in one hand (or two hands) of an operator and manipulated by onehand (or two hands) of the operator during a surgical procedure. Forinstance, in some versions, handpiece (22) may be grasped like a pencilby the operator. In some other versions, handpiece (22) may include ascissor grip that may be grasped like scissors by the operator. In someother versions, handpiece (22) may include a pistol grip that may begrasped like a pistol by the operator. Of course, handpiece (22) may beconfigured to be gripped in any other suitable fashion. Furthermore,some versions of instrument (20) may substitute handpiece (22) with abody that is coupled to a robotic surgical system that is configured tooperate instrument (e.g., via remote control, etc.). In the presentexample, a blade (24) extends distally from the handpiece (22).Handpiece (22) includes an ultrasonic transducer (26) and an ultrasonicwaveguide (28), which couples ultrasonic transducer (26) with blade(24). Ultrasonic transducer (26) receives electrical power fromgenerator (12) via cable (14). By virtue of its piezoelectricproperties, ultrasonic transducer (26) is operable to convert suchelectrical power into ultrasonic vibrational energy.

Ultrasonic waveguide (28) may be flexible, semi-flexible, rigid, or haveany other suitable properties. As noted above, ultrasonic transducer(26) is integrally coupled with blade (24) via ultrasonic waveguide(28). In particular, when ultrasonic transducer (26) is activated tovibrate at ultrasonic frequencies, such vibrations are communicatedthrough ultrasonic waveguide (28) to blade (24), such that blade (24)will also vibrate at ultrasonic frequencies. When blade (24) is in anactivated state (i.e., vibrating ultrasonically), blade (24) is operableto effectively cut through tissue and seal tissue. Ultrasonic transducer(26), ultrasonic waveguide (28), and blade (24) together thus form anacoustic assembly providing ultrasonic energy for surgical procedureswhen powered by generator (12). Handpiece (22) is configured tosubstantially isolate the operator from the vibrations of the acousticassembly formed by transducer (26), ultrasonic waveguide (28), and blade(24).

In some versions, ultrasonic waveguide (28) may amplify the mechanicalvibrations transmitted through ultrasonic waveguide (28) to blade (24).Ultrasonic waveguide (28) may further have features to control the gainof the longitudinal vibration along ultrasonic waveguide (28) and/orfeatures to tune ultrasonic waveguide (28) to the resonant frequency ofsystem (10). For instance, ultrasonic waveguide (28) may have anysuitable cross-sectional dimensions/configurations, such as asubstantially uniform cross-section, be tapered at various sections, betapered along its entire length, or have any other suitableconfiguration. Ultrasonic waveguide (28) may, for example, have a lengthsubstantially equal to an integral number of one-half system wavelengths(nλ/2). Ultrasonic waveguide (28) and blade (24) may be fabricated froma solid core shaft constructed out of a material or combination ofmaterials that propagates ultrasonic energy efficiently, such astitanium alloy (i.e., Ti—6Al—4V), aluminum alloys, sapphire, stainlesssteel, or any other acoustically compatible material or combination ofmaterials.

In the present example, the distal end of blade (24) is located at aposition corresponding to an anti-node associated with resonantultrasonic vibrations communicated through waveguide (28) (i.e., at anacoustic anti-node), in order to tune the acoustic assembly to apreferred resonant frequency f_(o) when the acoustic assembly is notloaded by tissue. When transducer (26) is energized, the distal end ofblade (24) is configured to move longitudinally in the range of, forexample, approximately 10 to 500 microns peak-to-peak, and in someinstances in the range of about 20 to about 200 microns at apredetermined vibratory frequency f_(o) of, for example, 55.5 kHz. Whentransducer (26) of the present example is activated, these mechanicaloscillations are transmitted through waveguide (28) to reach blade (24),thereby providing oscillation of blade (24) at the resonant ultrasonicfrequency. Thus, the ultrasonic oscillation of blade (24) maysimultaneously sever the tissue and denature the proteins in adjacenttissue cells, thereby providing a coagulative effect with relativelylittle thermal spread. In some versions, an electrical current may alsobe provided through blade (24) to also cauterize the tissue.

By way of example only, ultrasonic waveguide (28) and blade (24) maycomprise components sold under product codes SNGHK and SNGCB by EthiconEndo-Surgery, Inc. of Cincinnati, Ohio. By way of further example only,ultrasonic waveguide (28) and/or blade (24) may be constructed andoperable in accordance with the teachings of U.S. Pat. No. 6,423,082,entitled “Ultrasonic Surgical Blade with Improved Cutting andCoagulation Features,” issued Jul. 23, 2002, the disclosure of which isincorporated by reference herein. As another merely illustrativeexample, ultrasonic waveguide (28) and/or blade (24) may be constructedand operable in accordance with the teachings of U.S. Pat. No.5,324,299, entitled “Ultrasonic Scalpel Blade and Methods ofApplication,” issued Jun. 28, 1994, the disclosure of which isincorporated by reference herein. Other suitable properties andconfigurations of ultrasonic waveguide (28) and blade (24) will beapparent to those of ordinary skill in the art in view of the teachingsherein.

Handpiece (22) of the present example also includes a control selector(30) and an activation switch (32), which are each in communication witha circuit board (34). By way of example only, circuit board (34) maycomprise a conventional printed circuit board, a flex circuit, arigid-flex circuit, or may have any other suitable configuration.Control selector (30) and activation switch (32) may be in communicationwith circuit board (34) via one or more wires, traces formed in acircuit board or flex circuit, and/or in any other suitable fashion.Circuit board (34) is coupled with cable (14), which is in turn coupledwith control circuitry (16) within generator (12). Activation switch(32) is operable to selectively activate power to ultrasonic transducer(26). In particular, when switch (32) is activated, such activationprovides communication of appropriate power to ultrasonic transducer(26) via cable (14). By way of example only, activation switch (32) maybe constructed in accordance with any of the teachings of the variousreferences cited herein. Other various forms that activation switch (32)may take will be apparent to those of ordinary skill in the art in viewof the teachings herein.

In the present example, surgical system (10) is operable to provide atleast two different levels or types of ultrasonic energy (e.g.,different frequencies and/or amplitudes, etc.) at blade (24). To thatend, control selector (30) is operable to permit the operator to selecta desired level/amplitude of ultrasonic energy. By way of example only,control selector (30) may be constructed in accordance with any of theteachings of the various references cited herein. Other various formsthat control selector (30) may take will be apparent to those ofordinary skill in the art in view of the teachings herein. In someversions, when an operator makes a selection through control selector(30), the operator's selection is communicated back to control circuitry(16) of generator (12) via cable (14), and control circuitry (16)adjusts the power communicated from generator (12) accordingly the nexttime the operator actuates activation switch (32).

It should be understood that the level/amplitude of ultrasonic energyprovided at blade (24) may be a function of characteristics of theelectrical power communicated from generator (12) to instrument (20) viacable (14). Thus, control circuitry (16) of generator (12) may provideelectrical power (via cable (14)) having characteristics associated withthe ultrasonic energy level/amplitude or type selected through controlselector (30). Generator (12) may thus be operable to communicatedifferent types or degrees of electrical power to ultrasonic transducer(26), in accordance with selections made by the operator via controlselector (30). In particular, and by way of example only, generator (12)may increase the voltage and/or current of the applied signal toincrease the longitudinal amplitude of the acoustic assembly. As amerely illustrative example, generator (12) may provide selectabilitybetween a “level 1” and a “level 5,” which may correspond with a blade(24) vibrational resonance amplitude of approximately 50 microns andapproximately 90 microns, respectively. Various ways in which controlcircuitry (16) may be configured will be apparent to those of ordinaryskill in the art in view of the teachings herein. It should also beunderstood that control selector (30) and activation switch (32) may besubstituted with two or more activation switches (32). In some suchversions, one activation switch (32) is operable to activate blade (24)at one power level/type while another activation switch (32) is operableto activate blade (24) at another power level/type, etc.

In some alternative versions, control circuitry (16) is located withinhandpiece (22). For instance, in some such versions, generator (12) onlycommunicates one type of electrical power (e.g., just one voltage and/orcurrent available) to handpiece (22), and control circuitry (16) withinhandpiece (22) is operable to modify the electrical power (e.g., thevoltage of the electrical power), in accordance with selections made bythe operator via control selector (30), before the electrical powerreaches ultrasonic transducer (26). Furthermore, generator (12) may beincorporated into handpiece (22) along with all other components ofsurgical system (10). For instance, one or more batteries (not shown) orother portable sources of power may be provided in handpiece (22). Stillother suitable ways in which the components depicted in FIG. 1 may berearranged or otherwise configured or modified will be apparent to thoseof ordinary skill in the art in view of the teachings herein.

II. Overview of Exemplary Ultrasonic Surgical Instrument

The following discussion relates to various exemplary components andconfigurations for instrument (20). It should be understood that thevarious examples of instrument (20) described below may be readilyincorporated into a surgical system (10) as described above. It shouldalso be understood that the various components and operability ofinstrument (20) described above may be readily incorporated into theexemplary versions of instrument (110) described below. Various suitableways in which the above and below teachings may be combined will beapparent to those of ordinary skill in the art in view of the teachingsherein. It should also be understood that the below teachings may bereadily combined with the various teachings of the references that arecited herein.

In some instances it may be advantageous to include a variety offunctionalities in a single surgical instrument. For example, when usingultrasonic surgical instruments, it may be useful in some instances todeliver varying levels of power or energy to tissue. Particularly, someinstances may call for both cutting and sealing of tissue, but otherinstances may call for only sealing of tissue. Levels of energy and/orpower that may be applied in a “seal” mode and in a “cut and seal” modewill be apparent to persons skilled in the art in view of the teachingsherein. While increasing the functionality of a surgical instrument tooperate in a variety of modes may be advantageous, doing so may lead toan increased number of buttons, switches, and other control mechanismsthat an operator must understand and utilize. Therefore, it is desirableto provide increased functionality of surgical instruments withoutincreasing the complexity of use. The following examples provideenhanced control of power modes in variations of instrument (20),without providing an unduly complex user interface.

A. Instrument including Sensor for Detecting Characteristics of Operator

FIG. 2 illustrates an exemplary ultrasonic surgical instrument (110). Atleast part of instrument (110) may be constructed and operable inaccordance with at least some of the teachings of U.S. Pat. No.5,322,055; U.S. Pat. No. 5,873,873; U.S. Pat. No. 5,980,510; U.S. Pat.No. 6,325,811; U.S. Pat. No. 6,773,444; U.S. Pat. No. 6,783,524; U.S.Pat. No. 8,461,744; U.S. Pub. No. 2009/0105750; U.S. Pub. No.2006/0079874; U.S. Pub. No. 2007/0191713; U.S. Pub. No. 2007/0282333;U.S. Pub. No. 2008/0200940; U.S. Pub. No. 2010/0069940; U.S. Pub. No.2012/0112687; U.S. Pub. No. 2012/0116265; U.S. Pub. No. 2014/0005701;U.S. Pat. Pub. No. 2014/0114334; U.S. patent application Ser. No.14/028,717; and/or U.S. Pat. App. No. 61/410,603. The disclosures ofeach of the foregoing patents, publications, and applications areincorporated by reference herein. As described therein and as will bedescribed in greater detail below, instrument (120) is operable to cuttissue and seal or weld tissue substantially simultaneously. It shouldalso be understood that instrument (120) may have various structural andfunctional similarities with the HARMONIC ACE® Ultrasonic Shears, theHARMONIC WAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears,and/or the HARMONIC SYNERGY® Ultrasonic Blades. Furthermore, instrument(120) may have various structural and functional similarities with thedevices taught in any of the other references that are cited andincorporated by reference herein.

To the extent that there is some degree of overlap between the teachingsof the references cited herein, the HARMONIC ACE® Ultrasonic Shears, theHARMONIC WAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears,and/or the HARMONIC SYNERGY® Ultrasonic Blades, and the followingteachings relating to instrument (120), there is no intent for any ofthe description herein to be presumed as admitted prior art. Severalteachings herein will in fact go beyond the scope of the teachings ofthe references cited herein and the HARMONIC ACE® Ultrasonic Shears, theHARMONIC WAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears,and the HARMONIC SYNERGY® Ultrasonic Blades.

Instrument (110) of the present example comprises a handle assembly(120), a shaft assembly (130), and an end effector (140). Handleassembly (120) comprises a body (22) including a pistol grip (124) and apair of buttons (126). Handle assembly (120) also includes a trigger(128) that is pivotable toward and away from pistol grip (124). Itshould be understood, however, that various other suitableconfigurations may be used, including but not limited to a scissor gripconfiguration. End effector (140) includes an ultrasonic blade (160) anda pivoting clamp arm (144). Ultrasonic blade (160) may be configured andoperable just like ultrasonic blade (24) described above.

Clamp arm (144) is coupled with trigger (128) such that clamp arm (144)is pivotable toward ultrasonic blade (160) in response to pivoting oftrigger (128) toward pistol grip (124); and such that clamp arm (144) ispivotable away from ultrasonic blade (160) in response to pivoting oftrigger (128) away from pistol grip (124). Clamp arm (144) is thusoperable to cooperate with ultrasonic blade (160) to grasp and releasetissue; and clamp arm (144) is further operable to compress tissueagainst ultrasonic blade (160) to thereby enhance the communication ofultrasonic vibration from ultrasonic blade (160) to the tissue. Varioussuitable ways in which clamp arm (144) may be coupled with trigger (128)will be apparent to those of ordinary skill in the art in view of theteachings herein. In some versions, one or more resilient members areused to bias clamp arm (144) and/or trigger (128) to the open positionshown in FIG. 2.

An ultrasonic transducer assembly (112) extends proximally from body(122) of handle assembly (120). Transducer assembly (112) may beconfigured and operable just like transducer (26) described above.Transducer assembly (112) is coupled with a generator (116) via a cable(114). It should be understood that transducer assembly (112) receiveselectrical power from generator (116) and converts that power intoultrasonic vibrations through piezoelectric principles. Generator (116)may be configured and operable like generator (12) described above.Generator (116) may thus include a power source and control module thatis configured to provide a power profile to transducer assembly (112)that is particularly suited for the generation of ultrasonic vibrationsthrough transducer assembly (112). It should also be understood that atleast some of the functionality of generator (116) may be integratedinto handle assembly (120), and that handle assembly (120) may eveninclude a battery or other on-board power source such that cable (114)is omitted. Still other suitable forms that generator (116) may take, aswell as various features and operabilities that generator (116) mayprovide, will be apparent to those of ordinary skill in the art in viewof the teachings herein.

As shown in FIG. 2, by way of example, one of the buttons (126) may beassociated with a “seal” mode, such that actuating the particular one ofthe buttons (126) only seals tissue, but does not cut tissue, when thetissue is being clamped between clamp arm (144) and blade (160). Inparticular, activation of a first one of the buttons (136) may causevibration of ultrasonic blade (160) at a relatively low amplitude.Similarly, by way of further example, the other of the buttons (126) maybe associated with a “cut and seal” mode such that actuating theparticular one of the buttons (126) may seal and cut tissue when thetissue is being clamped between clamp arm (44) and blade (160). Inparticular, activation of a second one of the buttons (136) may causevibration of ultrasonic blade (160) at a relatively high amplitude.Other suitable operational modes that may be associated with buttons(126) will be apparent to persons skilled in the art in view of theteachings herein.

Still referring to FIG. 2, operational modes associated with buttons(126) may change depending on certain characteristics sensed byinstrument (110). In the present example, instrument (110) includes asensor (180) that is configured to sense whether the operator isleft-handed or right handed. Particularly, in the present example,sensor (180) is configured to detect or determine if the operator isholding instrument (110) in the operator's left hand or right hand byusing one or more various suitable sensing modalities. Suitable sensingmodalities include, but are not limited to inductive, capacitive,resistive, thermal, reflective, pressure, density, infrared/heat,lateral trigger load, lateral trigger deflection, accelerometer sensingduring trigger closure, and various other suitable sensing modalitiesthat will be apparent to persons skilled in the art in view of theteachings herein. Various suitable ways in which such sensing modalitiesmay be incorporated into instrument (110), and various suitable ways inwhich such sensing modalities may be used to sense whether the operatoris grasping handle assembly (120) in the operator's left hand or theoperator's right hand, will be apparent to those of ordinary skill inthe art in view of the teachings herein.

While one sensor (180) is shown in the present example, other versionsmay include various sensors of the same or different types. Moreover, itwill be understood that sensor (180) may be positioned in handleassembly (120), for example, according to which sensing modality isutilized. In some examples, however, sensor (180) may be positioned in adifferent portion of instrument (110), such as shaft assembly (130), endeffector (140), and/or other suitable parts of instrument (110). In someexamples, rather than buttons activating transducer (112), closure oftrigger (128) may activate transducer (112). In such examples, sensor(180) may sense the angle of trigger (128) relative to particularcomponents of instrument (110), such as, for example, pistol grip (124).In such examples where closure of trigger (128) initiates activation oftransducer (112), the prevention of early or unintended activation oftransducer (112) may be prevented. Other suitable methods for activatingtransducer (112) will be apparent to persons skilled in the art in viewof the teachings herein.

As shown, sensor (180) is in communication with a controller (190)which, in response to receiving sensed/detected information from sensor(180), may communicate to buttons (126), transducer (112), and/or othercomponents of instrument (110) the operational modes under whichinstrument (110) should operate upon actuation of buttons (126). Forexample, upon sensing that the operator is grasping handle assembly(120) with a particular hand, sensor (180) and controller (190)communicate to instrument (110) that actuation of one of buttons (126)should activate transducer (112) and blade (160) in a first operationalmode while actuation of the other of the buttons (126) should activatetransducer (112) and blade (160) in a second operational mode.

In addition to buttons (126), instrument (110) of the present examplefurther includes a button (192) on each side of handle assembly (120).Such buttons (192) are positioned such that one of the buttons (192) maybe engaged by the thumb of the hand that grasps pistol grip (124), theparticular button (192) depending on which hand the operator uses tograsp pistol grip (124). While button (192) is shown on one side ofhandle assembly (120), it will be understood that another button (192)is positioned on the other side of handle assembly (120) that is notshown. In some versions, buttons (192) are operable to activatetransducer (112) to drive blade (160) to vibrate at an ultrasonicfrequency. In some such versions, one or both of buttons (126) is/areomitted. For instance, the single button (126) may provide ultrasonicenergy at one power level while the other button (192) may provideultrasonic energy at another power level. In some other versions,buttons (192) are operable to activate features that are configured toapply RF electrosurgical energy to tissue via end effector (140). By wayof example only, buttons (192) may be configured and operable inaccordance with at least some of the teachings of U.S. Pub. No.2015/0141981, entitled “Ultrasonic Surgical Instrument withElectrosurgical Feature,” published May 21, 2015, the disclosure ofwhich is incorporated by reference herein. By way of further exampleonly, end effector (140) may incorporate RF electrosurgicalfunctionality in accordance with at least some of the teachings of U.S.Pat. No. 8,663,220, entitled “Ultrasonic Surgical Instruments,” issuedMar. 4, 2014, the disclosure of which is incorporated by referenceherein. Other suitable functionalities that may be tied to buttons(192), and other suitable ways in which end effector (140) mayincorporate RF electrosurgical functionality, will be apparent to thoseof ordinary skill in the art in view of the teachings herein.

In the present example, controller (190) is configured to selectivelyenable one button (192) while disabling the other button (192) based onwhich hand the operator uses to grasp handle assembly (120), as detectedby sensor (180). For example, upon detecting that the operator isgrasping handle assembly (120) in the operator's left hand, controller(190) may enable the button (192) on the right side of handle assembly(120) (i.e., where the operator's left thumb would be located) anddisable the button (192) on the left side of handle assembly (120).Thus, if the operator who grasps handle assembly (120) in the operator'sleft hand actuates the button (192) on the right side of handle assembly(120), the actuation of the right side button (192) will triggerultrasonic vibration of blade (160) and/or application of RF energy totissue via end effector (140). If the same operator who grasps handleassembly (120) in the operator's left hand incidentally actuates thebutton (192) on the left side of handle assembly (120), the actuation ofthe left side button (192) will have no effect.

Conversely, if an operator who grasps handle assembly (120) in theoperator's right hand actuates the button (192) on the left side ofhandle assembly (120) (i.e., where the operator's right thumb would belocated), the actuation of the left side button (192) will triggerultrasonic vibration of blade (160) and/or application of RF energy totissue via end effector (140). If the same operator who grasps handleassembly (120) in the operator's right hand incidentally actuates thebutton (192) on the right side of handle assembly (120), the actuationof the right side button (192) will have no effect.

As another merely illustrative variation, controller (190) may stillenable both buttons (192) during operation of instrument (110), yetprovide different functionality in response to actuation of each button(192) based on the hand that the operator uses to grasp handle assembly(120). For instance, when the operator grasps handle assembly (120) withthe operator's left hand, controller (190) may provide a firstfunctionality in response to actuation of the left side button (192) anda second functionality in response to actuation of the right side button(192). Other suitable operational modes under which instrument (110) mayoperate in response to data sensed by sensor (180), and other responsesthat instrument (110) may provide based on data sensed by sensor (180),will be apparent to persons skilled in the art in view of the teachingsherein.

B. Surgical Instrument with Multi-Position Toggle Activation Button

FIGS. 3-4C show an exemplary alternative surgical instrument (210) thatis configured to operate substantially similar to surgical instrument(110). Therefore, identical or similar structures are labeled with likereference numerals without further explanation below. It will beunderstood that although an end effector is not shown in FIG. 3,instrument (210) includes an end effector that is just like end effector(140) described above. It will be further understood that transducer(112) may be in communication with a generator (12, 116) via cable (14).Surgical instrument (210) of this example includes a single activationbutton (226) that is configured to transition between various positions.As discussed in detail below, instrument (210) is configured to operatein different operational modes, depending on the position of activationbutton (226) upon the actuation of activation button (226).

In the present example, button (226) is configured to toggle among threepositions, each of which is associated with different operational modes.Once button (226) is positioned into one of the three positions (alongbi-directional arrow (228)), button may be pressed or otherwise actuated(e.g., in the direction of arrow (230)) to activate transducer (112) andthereby activate blade (160). In the example shown, in the firstposition (FIG. 4A) button (226) is laterally centered. In the secondposition, as shown in FIG. 4B, button (226) has been pivoted in a firstdirection about an axis that is perpendicular to the longitudinal axisof instrument, such that button (226) is deflected to a first side ofthe laterally centered positioned. In the third position as shown inFIG. 4C, button (226) has been pivoted in a second direction (oppositeof the first direction) about an axis that is perpendicular to thelongitudinal axis of instrument (210), such that button (226) isdeflected to a second side of the laterally centered positioned. Whilebutton (226) is shown as pivoting about an axis to transition betweenthe first, second, and third positions, other versions may provide apurely lateral movement of button (226) (i.e., along a straight, linearpath) to transition between first, second, and third positions.

In some versions, button (226) includes detent features that selectivelymaintain the position of button (226) in the position selected from thefirst, second, and third positions. Such detent features may providesome degree of resistance to movement between the first, second, andthird positions (i.e., to prevent inadvertent movement between thefirst, second, and third positions); yet still permit intended movementbetween the first, second, and third positions. Various suitable formsthat such detent features may take will be apparent to those of ordinaryskill in the art in view of the teachings herein. In addition or in thealternative, button (226) may be resiliently biased toward the firstposition such that the operator must overcome the resilient bias inorder to achieve the second or third positions. In some such versions,the operator must maintain a retention force in order to maintain thesecond or third position. Once the operator removes the retention force,button (226) will be resiliently urged back to the first position.

While button (226) is shown as being operable to transition betweenthree positions, it will be understood that button (226) may be operableto assume more than three positions or less than three positions. Whilebutton (226) is shown to be rotated or pivoted along an axis that isperpendicular to the longitudinal axis of instrument (210) to be movedamongst the first, second, and third positions, it will be understoodthat button may be rotated about differently oriented axes and/ortranslated along different axes to assume a variety of positionsassociated with various operating modes. Other suitable configurationsof button (226) will be apparent to persons skilled in the art in viewof the teachings herein.

In the example shown, button (226) is not capable of activatingtransducer (112) and blade (160) when button (226) is in the firstposition. In some versions, instrument (210) includes a locking elementthat physically resists or impedes the actuation of button (226) frommoving in the direction of arrow (230) when button (226) is in the firstposition. In some other versions, button (226) may be physicallyactuated in the direction of arrow (230) while button (226) is in thefirst position, but such actuation of button (226) in the first positiondoes not result in activation of transducer (112) and blade (160). Forinstance, button (226) may be incapable of closing an activation circuitwhen button (226) is in the first position. In still other examples,button (226) will activate end effector (140) in a first operationalmode (e.g., low ultrasonic energy, high ultrasonic energy, RF energy,etc.) when button (226) is actuated while button (226) is at the firstposition.

In the present example, actuation of button (226) in the second positionactivates transducer (112) and blade (160) at a first power level, whileactuation of button (226) in the third position activates transducer(112) and blade (160) at a second power level. By way of example only,the first power level may provide the “seal” mode described above; whilethe second power level may provide the “cut and seal” mode describedabove. In other versions, the different positions of button (226) may beassociated with other, different power levels or activation modes.Moreover, in addition or in the alternative to discrete positions of thebutton (226) being associated with particular operating modes, togglingthe button in the first or second direction may change the power levelin a continuous, linear manner, instead of a step-like manner. Variouscomponents and configurations that may be incorporated into instrument(210) in order to provide the above-described responses based on theposition of button (226) will be apparent to those of ordinary skill inthe art in view of the teachings herein.

C. Surgical Instrument with Adjustable, Scrolling Activation Button

FIGS. 5-6 show an exemplary alternative surgical instrument (310) thatis configured to operate substantially similar to surgical instrument(110). Therefore, identical or similar structures are labeled with likereference numerals without further explanation below. It will beunderstood that although an end effector is not shown in FIG. 4,instrument (310) includes an end effector that is just like end effector(140) described above. It will be further understood that transducer(112) may be in communication with a generator (12, 116) via cable (14).Surgical instrument (310) includes a single activation button (326),which is rotatable to select a power level or activation mode, which isshown on a power level display (328). Therefore, as discussed in detailbelow, instrument (310) is configured to operate in differentoperational modes, depending on the rotational position of activationbutton (326) upon the actuation of activation button (326).

Particularly, button (326) is rotatable about an axis that isperpendicular to a longitudinal axis of shaft assembly (130). In theexample shown, rotating button (326) in a first direction (left as shownin FIG. 6) results in the power level increasing, while rotating buttonin a second direction (right as shown in FIG. 4) results in the powerlevel decreasing. However, in other examples, rotation in the firstdirection may result in the power level decreasing and rotation in thesecond direction may result in the power level increasing. In thepresent example, button (326) is associated with a potentiometer thatincreases or decreases the power level linearly and continuously asbutton (326) is rotated in the first or second directions, respectively.

In some other examples, however, rotation of button (326) may result instep-wise increasing or decreasing among discrete power levels oroperational modes. For example, rotation of button (326) in the firstdirection may increase the power level from zero, to a power levelassociated with the “seal” activation mode described above, to a powerlevel associated with the “cut and seal” activation mode describedabove, and any suitable number of modes between zero and “seal,” between“seal” and “cut and seal,” and above “cut and seal.” Similarly, rotationof button (326) in the second direction may decrease the power levelfrom, for example, the power level associated with the “cut and seal”activation mode, to the “seal” activation mode, and to zero, and anysuitable number of modes between “cut and seal” and “seal,” and between“seal” and zero. Other suitable activation modes that may be providedaccording to the positioning of button (326) will be apparent to personsskilled in the art in view of the teachings herein. In versions whererotation of button (326) provides step-wise increasing or decreasingamong discrete power levels or operational modes, detent features and/orother features may provide tactile and/or audible feedback to indicateto the operator that instrument (310) is transitioning between thediscrete power levels or operational modes.

As shown, button (326) may be rotated until the maximum power level isreached upon which the button (326) is impeded from further rotation inthe first direction. Similarly, button may be rotated in the seconddirection until the minimum power level (e.g., zero power) is reached.Various suitable mechanical or other manners of impeding the furtherrotation of button (326) will be apparent to persons skilled in the artin view of the teachings herein. In some examples, however, button (326)may continue to be rotated after the power level has reached the minimumand maximum. In such examples, instrument (310) may include any suitableelectronic controls to prevent the power level from increasing above apredetermined maximum power level.

While button (326) is shown to be rotated about an axis that isperpendicular to the longitudinal axis of shaft assembly (130) toincrease or decrease the power level, it will be understood that button(326) may be rotated along differently positioned axes to assume avariety of positions that are associated with a variety of power levels.Moreover, in some examples, rather than being rotated, button (326) maybe translated (e.g. parallel, perpendicular, or oblique to longitudinalaxis) in order to increase or decrease the power level.

Power level display (328) is configured to provide the operator withvisual feedback indicating the power level selected by rotation ofbutton (326). As shown, display (328) includes a proximal end (332)associated with a low power level and a distal end (334) associated witha high power level. In the present example, as the power levelincreases, different portions of display (328) are illuminated. Forexample, as the power level increases, more distal portions of display(328) are progressively illuminated. In some examples, display (328)includes colors associated with the power levels. In such examples,green and yellow colors may indicate a relatively lower power level,while orange and red may indicate relatively higher power level. By wayof example only, display (328) may include a linear array of LEDs orother light sources. Other suitable components and configurations thatmay be used to provide display (328) will be apparent to persons skilledin the art in view of the teachings herein.

D. Surgical Instrument with Continuously Variable Activation Button

FIG. 7 shows an exemplary alternative surgical instrument (410) that isconfigured to operate substantially similar to surgical instrument(110). Therefore, identical or similar structures are labeled with likereference numerals without further explanation below. It will beunderstood that although an end effector is not shown in FIG. 7,instrument (410) includes an end effector just like end effector (140)described above. It will be further understood that transducer (112) maybe in communication with a generator (12, 116) via cable (14). As shown,surgical instrument (410) includes a single activation button (426) thatis configured to provide a continuously variable power level, ratherthan operating in discrete modes or power levels. Particularly, in theexample shown, as the depth of proximal actuation of button (436)increases, the power level of transducer (112) and blade (160)increases.

In the present example, and as shown in FIG. 8, the power setting ordisplacement of ultrasonic blade (160) increases linearly as the depthof button (436) press increases. In some other examples, however, thepower setting or displacement of ultrasonic blade (160) may increase atnon-linear rate, such as step-wise, exponentially, etc. Other suitablerelationships between the power setting or displacement of ultrasonicblade (160) and the depth or pressure of button (426) will be apparentto persons skilled in the art in view of the teachings herein. In someexamples, the tension or physical resistance of button (436) may bevaried across the throw (i.e., across the range of travel of button(436)) in order to provide the operator with tactile feedback and morecontrol over the movement of button (436) and ultrasonic blade (160).Providing button (436) with a continuously variable power level enablesthe operator to operate across a continuum of modes (e.g., power levels)without being constrained to discrete settings (maximum, minimum, etc.).

E. Surgical Instrument with Multi-Function, Single Activation Button

FIG. 9 shows an exemplary alternative surgical instrument (510) that isconfigured to operate substantially similar to surgical instrument(110). Therefore, identical or similar structures are labeled with likereference numerals without further explanation below. It will beunderstood that although an end effector is not shown in FIG. 9,instrument (510) includes an end effector that is just like end effector(140). It will be further understood that transducer (112) may be incommunication with a generator (12, 116) via cable (14).

As shown, instrument (510) includes a single activation button (526)having a plurality of switches associated with various operating modes.In the present example, button (526) is a multi-directional buttonhaving a first leg (526 a), a second leg (526 b), a third leg (526 c),and a fourth leg (526 d). Legs (526 a, 526 b, 526 c, 526 d) areperpendicular to each other and thereby define a “+” configuration. Insome other versions, button (526) has a round shape or some otherconfiguration. It should be understood that each leg (526 a, 526 b, 526c, 526 d) may be pressed separately; or a pair of legs (526 a, 526 b,526 c, 526 d) may be pressed simultaneously. When one or more legs arepressed (526 a, 526 b, 526 c, 526 d), button (526) will close one ormore corresponding switches to thereby activate end effector (140) asdescribed in greater detail below.

By way of example only, first leg (526 a) may be associated with a“maximum” setting, second leg (526 b) may be associated with a “minimum”setting, and third and fourth legs (526 c, 526 d) may be associated witha “hemostasis” setting. Levels of energy and/or power that may beapplied in the “minimum,” “maximum,” and “hemostasis” modes will beapparent to persons skilled in the art in view of the teachings herein.It should also be understood that button (526) may be operable toprovide selection from ultrasonic and RF power delivery modes. Forinstance, first and second legs (526 a, 526 b) may be operable toprovide ultrasonic energy at end effector (140) at two different powerlevels; and third and fourth legs (526 c, 526 d) may be operable toprovide RF energy at end effector (140) at two different power levels.

In the present example, button (526) includes four legs (526 a, 526 b,526 c, 526 d) that allow for at least two operating modes. In versionswhere third and fourth legs (526 c, 526 d) each activate a “hemostasis”operating mode (or other operating mode), due to the opposing lateralpositions of third and fourth legs (526 c, 526 d), a practitioner mayeasily utilize the “hemostasis” operating mode (or other operating mode)regardless of the operator's or her left-handedness or right-handedness.That is, third leg (526 c) may be more easily accessible to aright-handed person than is fourth leg (526 d). Similarly, fourth leg(526 d) may be more easily accessible to a left-handed person than isthird leg (526 c). Due to the locations of first and second legs (526 a,526 b) being coincident with the longitudinal axis of instrument (510),a practitioner may easily access either of first and second legs (526 a,526 b) regardless of the left-handedness or right-handedness of thepractitioner. As shown in FIG. 9, button (526) extends along a planethat is perpendicular to the longitudinal axis of shaft assembly (130).However, in other examples, button (526) may extend along a plane thatis obliquely oriented relative to the longitudinal axis of shaftassembly (130).

FIG. 10 shows one example of a layout of switches (550 a, 550 b) thatmay be associated with button (526). In particular, switches (550 a, 550b) may be laid under button (526) such that at least one switch (550 a,550 b) will be closed when button (526) is actuated. In some suchversions, switch (550 a) is positioned such that switch (550 a) will beclosed when at least one of legs (526 a, 526 c, 526 d) or the center ofbutton (526) is actuated; but not when leg (526 b) is actuated. Switch(550 b) is positioned such that switch (550 b) will be closed when atleast one of legs (526 b, 526 c, 526 d) or the center of button (526) isactuated; but not when leg (526 a) is actuated. It should therefore beunderstood that if button (526) is not being actuated, then bothswitches (550 a, 550 b) are open. If the operator actuates leg (526 a),switch (550 a) is closed. If the operator actuates leg (526 b), switch(550 b) is closed. If the operator actuates either leg (526 c), leg (526d), or the center of button (526), both switches (550 a, 550 b) will beclosed.

In some versions where the layout of switches (550 a, 550 b) of FIG. 10is used, a control logic (e.g., within instrument (510) and/or withingenerator (116)) is programmed with a control algorithm that provides apower selection in response to closure of a single switch (550 a, 550 b)and activation in response to closure of both switches (550 a, 550 b)simultaneously. For instance, an operator may first press either leg(526 a) or leg (526 b) to close only switch (550 a) or only switch (550b), respectively. If the operator actuates leg (526 a) and therebycloses only switch (550 a), the control logic may select a first powerlevel. If the operator actuates leg (526 b) and thereby closes onlyswitch (550 b), the control logic may select a second power level. Oncethe operator has selected a power level by actuating either leg (526 a)or leg (526 b), the operator may then actuate either leg (526 c) or leg(526 d), thereby closing both switches (550 a, 550 b) simultaneously. Inresponse to the simultaneous closure of both switches (550 a, 550 b),the control logic may provide activation of the end effector at theselected power level, regardless of whether the operator has actuatedleg (526 c) or leg (526 d).

FIG. 11 shows another example of a layout of switches (552 a, 552 b, 552c) that may be associated with button (526). In particular, switches(552 a, 552 b, 552 c) may be laid under button (526) such that at leastone switch (552 a, 552 b, 552 c) will be closed when button (526) isactuated. In some such versions, switch (552 a) is positioned such thatswitch (552 a) will be closed when at least one of legs (526 a, 526 c,526 d) or the center of button (526) is actuated; but not when leg (526b) is actuated. Switch (552 b) is positioned such that switch (552 b)will be closed when at least one of legs (526 b, 526 d) or the center ofbutton (526) is actuated; but not when legs (526 a, 526 c) are actuated.Switch (552 c) is positioned such that switch (552 c) will be closedwhen at least one of legs (526 b, 526 c) or the center of button (526)is actuated; but not when legs (526 a, 526 d) are actuated. It shouldtherefore be understood that if button (526) is not being actuated, thenall switches (552 a, 552 b, 552 c) are open. If the operator actuatesleg (526 a), switch (552 a) is closed. If the operator actuates leg (526b), switches (552 b, 552 c) are closed. If the operator actuates leg(526 c), switches (552 a, 552 c) are closed. If the operator actuatesleg (526 d), switches (552 a, 552 b) are closed. If the operatoractuates the center of button (526), all switches (552 a, 552 b, 552 c)will be closed. Various suitable control algorithms that may be executedin response to various permutations of switch (552 a, 552 b, 552 c)closures will be apparent to those of ordinary skill in the art in viewof the teachings herein.

FIG. 12 shows another example of a layout of switches (554 a, 554 b, 554c, 554 d) that may be associated with button (526). In particular,switches (554 a, 554 b, 554 c, 554 d) may be laid under button (526)such that at least one switch (554 a, 554 b, 554 c, 554 d) will beclosed when button (526) is actuated. In some such versions, switch (554a) is positioned such that switch (554 a) will be closed when leg (526a) or the center of button (526) is actuated. Switch (554 b) ispositioned such that switch (554 b) will be closed when leg (526 d) orthe center of button (526) is actuated. Switch (554 c) is positionedsuch that switch (554 c) will be closed when leg (526 c) or the centerof button (526) is actuated. Switch (554 d) is positioned such thatswitch (554 d) will be closed when leg (526 b) or the center of button(526) is actuated. If button (526) is not being actuated, then allswitches (554 a, 554 b, 554 c, 554 d) are open.

Continuing with the example of FIG. 12, if the operator actuates leg(526 a), switch (554 a) is closed. If the operator actuates leg (526 b),switch (554 b) is closed. If the operator actuates leg (526 c), switch(554 c) is closed. If the operator actuates leg (526 c), switch (554 c)is closed. If the operator actuates legs (526 a, 526 d) simultaneously,switches (554 a, 554 b) are closed. If the operator actuates legs (526d, 526 b) simultaneously, switches (554 b, 554 c) are closed. If theoperator actuates legs (526 b, 526 c) simultaneously, switches (554 c,554 d) are closed. If the operator actuates legs (526 c, 526 a)simultaneously, switches (554 d, 554 a) are closed. If the operatoractuates the center of button (526), all switches (554 a, 554 b, 554 c,554 d) will be closed. Various suitable control algorithms that may beexecuted in response to various permutations of switch (554 a, 554 b,554 c, 554 d) closures will be apparent to those of ordinary skill inthe art in view of the teachings herein.

Other suitable configurations of buttons and switches, and power levelsand operating modes associated therewith, will be apparent to personsskilled in the art in view of the teachings herein.

F. Surgical Instrument with Dual Stage Switch

FIG. 13 shows an exemplary alternative surgical instrument (610) that isconfigured to operate substantially similar to surgical instrument(110). Therefore, identical or similar structures are labeled with likereference numerals without further explanation below. It will beunderstood that although an end effector is not shown in FIG. 13,instrument (510) includes an end effector just like end effector (140).It will be further understood that transducer (112) may be incommunication with a generator (12, 116) via cable (14). As shown,instrument (610) includes a dual stage switch (626) comprising a firstswitch (626 a) and a second switch (626 b). Switches (626 a, 626 b) arecoaxially aligned with each other in this example. As discussed infurther detail below, actuating or depressing first switch (626 a)activates transducer (112) to operate in a first operating mode, whiledepressing both first and second switches (626 a, 626 b) togetheractivates transducer (112) to operate in a second operating mode.

As shown, first switch (626 a) defines a central opening (628) extendingbetween a distal end (630) and a proximal end (632) of the first switch(626 a). First switch (626 a) includes a proximal flange (634). Secondswitch (626 a) includes a rod member (636) that is shaped and configuredto be received in opening (628) of first switch (626 a). Second switch(626 b) includes a proximal flange (638) extending radially outwardlyfrom rod member (636). As shown, opening (628) has a generally squarecross-sectional shape while rod member (636) also has a generally squarecross-sectional shape. In other examples, however, portions of first andsecond switches (626 a, 626 b), including opening (628) and rod (636)may have any other suitable cross-sectional shapes (e.g., circular,etc.).

In the present example, first and second switches (626 a, 626 b) areco-located such that an operator may depress first and second switches(626 a, 626 b) simultaneously if desired. More particularly, first andsecond switches (626 a, 626 b) are oriented coaxially relative to oneanother such that first and second switches extend along an axis that isparallel to, but offset from, the longitudinal axis of shaft assembly(130). In other examples, first and second switches (626 a, 626 b) maybe co-located but not necessarily coaxial with one another. In theexample shown, first and second switches (626 a, 626 b) are each incommunication with a respective resilient member (640 a, 640 b) thateach bias the corresponding first and second switches (626 a, 626 b)distally relative to housing (122) (e.g., toward end effector (40)).

Switch (626) of the present example is movable among three positions toswitch instrument (610) among various operating modes, as discussed infurther detail below. In the first position of switch (626) as shown inFIG. 14A, both first and second switches (626 a, 626 b) are in distallyextended position relative to housing (122). Switches (626 a, 626 b) areconfigured such that rod member (636) is recessed within opening (628),with rod member (636) being proximal to distal end (630), in the firstposition. In the second position, as shown in FIG. 14B, second switch(626 b) remains substantially in the same position as shown in FIG. 14Aand first switch (626 a) has been actuated or depressed proximally afterproviding a sufficient force to overcome the distal bias of firstresilient member (640 a). It should therefore be understood that firstswitch (626 a) is configured to translate proximally through a firstrange of motion while second switch (626 b) remains stationary. Asshown, proximal flange (634) of first switch (626 a) abuts proximalflange (638) of second switch (626 b) in the second position such thatfurther proximal movement of first switch (626 a) will drive secondswitch (626 b) proximally. In some examples, second resilient member(640 b) is configured to resist further proximal movement of firstswitch (626 a) absent a sufficient additional force by a user on theswitch (626).

As shown in FIG. 14B, in the second position, a distal portion (642) ofrod member (636) extends slightly distally of the distal end (630) offirst switch (626 a). Therefore, due to multiple features of switch(626), upon depressing the first switch (626 a) relative to secondswitch (626 b), an operator is provided with further tactile feedbackthat informs the operator of the position of switch (626) (and thus theoperating mode of instrument (610), discussed further below). First, theoperator's finger may contact the distal portion (642) of rod member(636) and feel that distal portion (642) of rod member (636) hasextended distally of distal end (630). Moreover, in some instances theoperator may feel the resistance preventing first and second switches(626 a, 626 b) from moving further proximally due to the bias fromresilient members (640 a, 640 b). Additionally or alternatively, theoperator may sense or feel tactile feedback from flanges (634, 638)contacting one another.

In order to move switch (626) to the third position as shown in FIG.13C, the operator may further depress or actuate proximally both of thefirst and second switches (626 a, 626 b) together. As discussed above,the operator depresses first and second switches (626 a, 626 b) with asufficient force to overcome the distal resilient bias of resilientmembers (640 a, 640 b) in order to transition switch (626) to the thirdposition. In some examples, instrument (610) may include anotherpositive stop feature that prevents the operator from retracting firstand second switches (626 a, 626 b) further proximally (e.g. proximallypast the third position shown in FIG. 13C), providing another tactilefeedback feature that informs the operator of the position of switch(626).

In the present example, when switch (626) is in the first position,transducer (112) and blade (160) are in a non-activated state. Whenswitch (626) is in the second position, transducer (112) and blade (160)are activated in a first operating mode or power level. The firstoperating mode may be any of the operating modes discussed herein orother operating modes that will be apparent to persons skilled in theart in view of the teachings herein. For example, the first operatingmode may be the “seal” mode discussed above. When switch (626) is in thethird position, transducer (112) and blade (160) are activated in asecond operating mode or power level. The second operating mode may beany of the operating modes discussed herein or other operating modesthat will be apparent to persons skilled in the art in view of theteachings herein. For example, the second operating mode may be the “cutand seal” mode discussed above. Other suitable operating modes andconfigurations of switch (626) will be apparent to persons skilled inthe art in view of the teachings herein.

III. Exemplary Combinations

The following examples relate to various non-exhaustive ways in whichthe teachings herein may be combined or applied. It should be understoodthat the following examples are not intended to restrict the coverage ofany claims that may be presented at any time in this application or insubsequent filings of this application. No disclaimer is intended. Thefollowing examples are being provided for nothing more than merelyillustrative purposes. It is contemplated that the various teachingsherein may be arranged and applied in numerous other ways. It is alsocontemplated that some variations may omit certain features referred toin the below examples. Therefore, none of the aspects or featuresreferred to below should be deemed critical unless otherwise explicitlyindicated as such at a later date by the inventors or by a successor ininterest to the inventors. If any claims are presented in thisapplication or in subsequent filings related to this application thatinclude additional features beyond those referred to below, thoseadditional features shall not be presumed to have been added for anyreason relating to patentability.

EXAMPLE 1

An ultrasonic instrument comprising: (a) a body; (b) an actuationassembly, wherein the actuation assembly comprises an activation member,wherein the activation member is operable to move in a first directionto select a mode of operation; (c) a shaft assembly extending distallyfrom the body, wherein the shaft assembly defines a longitudinal axis,wherein the shaft assembly comprises an acoustic waveguide; and (d) anend effector comprising an ultrasonic blade, wherein the ultrasonicblade is in acoustic communication with the acoustic waveguide, whereinthe activation member is operable to move in a second direction toactivate the end effector in a mode of operation selected by movement ofthe activation member in the first direction.

EXAMPLE 2

The ultrasonic instrument of Example 1, wherein the end effector isconfigured to be activated in a first activation mode in response tomovement of the activation member in the second direction when theactivation member is in a first position, wherein the end effector isconfigured to be activated in a second activation mode in response tomovement of the activation member in the second direction when theactivation member is in a second position.

EXAMPLE 3

The ultrasonic instrument of any one or more of Examples 1 through 2,wherein the activation member comprises a rotatable wheel, wherein therotatable wheel is configured to rotate about a rotational axis that isperpendicular to the longitudinal axis of the shaft assembly to select amode of operation, wherein the second direction is transverse to therotational axis.

EXAMPLE 4

The ultrasonic instrument of any one or more of Examples 1 through 3,wherein the activation member comprises a button, wherein the button ismovable laterally in the first direction.

EXAMPLE 5

The ultrasonic instrument of Example 4, wherein the button is pivotablelaterally in the first direction about a pivot axis that isperpendicular to the longitudinal axis of the shaft assembly.

EXAMPLE 6

The ultrasonic instrument of Example 5, wherein the pivotable button isconfigured to pivot in the first direction between a first position, asecond position, and a third position, wherein the second position isbetween the first and third positions.

EXAMPLE 7

The ultrasonic instrument of Example 6, wherein the pivotable button isresiliently biased to the second position.

EXAMPLE 8

The ultrasonic instrument of any one or more of Examples 6 through 7,wherein the pivotable button is inoperable to activate the end effectorwhen the pivotable button is in the second position.

EXAMPLE 9

The ultrasonic instrument of any one or more of Examples 1 through 8,wherein the activation member is configured to select between a firstmode of operation and a second mode of operation, wherein the endeffector is configured to apply ultrasonic energy to tissue at a firstpower level in the first mode of operation, wherein the activationmember is configured to apply ultrasonic energy to tissue at a secondpower level in the second mode of operation.

EXAMPLE 10

The ultrasonic instrument of any one or more of Examples 1 through 9,wherein the activation member is configured to select between a firstmode of operation and a second mode of operation, wherein the endeffector is configured to apply ultrasonic energy to tissue in the firstmode of operation, wherein the activation member is configured to applyRF energy to tissue in the second mode of operation.

EXAMPLE 11

The ultrasonic instrument of any one or more of Examples 1 through 10,wherein the body is configured to be grasped by a hand of an operator.

EXAMPLE 12

The ultrasonic instrument of Example 11, further comprising a sensor,wherein the sensor is configured to sense whether the body is grasped bya right hand or a left hand of an operator.

EXAMPLE 13

The ultrasonic instrument of Example 12, further comprising a controllerin communication with the sensor, wherein the actuation assembly furthercomprises a first lateral actuator and a second lateral actuator,wherein the first and second lateral actuators are on opposite lateralsides of the body, wherein the controller is operable to varyfunctionality of the first and second lateral actuators based on datafrom the sensor indicating whether the body is grasped by a right handor a left hand of an operator.

EXAMPLE 14

The ultrasonic instrument of Example 13, wherein the activation memberis operable to activate the end effector to apply ultrasonic energy totissue via the ultrasonic blade, wherein the first lateral actuator orthe second lateral actuator is operable to activate the end effector toapply RF electrosurgical energy to tissue.

EXAMPLE 15

The ultrasonic instrument of any one or more of Examples 1 through 14,further comprising a visual indicator on the body, wherein the visualindicator is configured to provide visual feedback indicating a mode ofoperation selected through movement of the activation member in thefirst direction.

EXAMPLE 16

An ultrasonic instrument comprising: (a) a body; (b) a button assembly,wherein the button assembly comprises: (i) a first button memberdefining an opening and a distal face, and (ii) a second button memberpositioned within the opening of the first button member; (c) a shaftassembly extending distally from the body; and (d) an end effectorpositioned at a distal end of the shaft assembly, wherein the endeffector is operable to apply one or both of ultrasonic energy or RFelectrosurgical energy to tissue; wherein the first button member isconfigured to translate through a first range of motion relative to thebody to activate the end effector in a first mode of operation, whereinthe second button member is configured to remain stationary relative tothe body as the first button member translates through the first rangeof motion; wherein the first button member is configured to translatethrough a second range of motion relative to the body to activate theend effector in a second mode of operation, wherein the second buttonmember is configured to translate with the first button member relativeto the body as the first button member translates through the secondrange of motion.

EXAMPLE 17

The ultrasonic instrument of Example 16, wherein the second buttonmember has a distal end, wherein the distal end is recessed within theopening and relative to the distal face of the first button member untilthe first button member translates through the first range of motion.

EXAMPLE 18

The ultrasonic instrument of any one or more of Examples 16 through 17,wherein the first button member has a proximal flange, wherein thesecond button member has a proximal flange, wherein the proximal flangeof the first button member is configured to engage the proximal flangeof the second button member upon completion of the first range of motionby the first button member.

EXAMPLE 19

An ultrasonic instrument comprising: (a) a body; (b) an actuationassembly, wherein the actuation assembly comprises an activation member,wherein the activation member is operable to move along a range ofmotion relative to the body; (c) a shaft assembly extending distallyfrom the body, wherein the shaft assembly defines a longitudinal axis,wherein the shaft assembly comprises an acoustic waveguide; and (d) anend effector comprising an ultrasonic blade, wherein the ultrasonicblade is in acoustic communication with the acoustic waveguide, whereinthe activation member is operable to activate the ultrasonic blade at aprogressively increasing power level along a continuous range of powerlevels based on the position of the activation member along the range ofmotion relative to the body.

EXAMPLE 20

The ultrasonic instrument of Example 19, wherein the activation memberis operable to activate the ultrasonic blade at a progressivelyincreasing power level along a continuous range of power levels that isproportional to the position of the activation member along the range ofmotion relative to the body.

IV. MISCELLANEOUS

It should be understood that any of the versions of instrumentsdescribed herein may include various other features in addition to or inlieu of those described above. By way of example only, any of theinstruments described herein may also include one or more of the variousfeatures disclosed in any of the various references that areincorporated by reference herein. It should also be understood that theteachings herein may be readily applied to any of the instrumentsdescribed in any of the other references cited herein, such that theteachings herein may be readily combined with the teachings of any ofthe references cited herein in numerous ways. Other types of instrumentsinto which the teachings herein may be incorporated will be apparent tothose of ordinary skill in the art.

It should also be understood that any ranges of values referred toherein should be read to include the upper and lower boundaries of suchranges. For instance, a range expressed as ranging “betweenapproximately 1.0 inches and approximately 1.5 inches” should be read toinclude approximately 1.0 inches and approximately 1.5 inches, inaddition to including the values between those upper and lowerboundaries.

It should be appreciated that any patent, publication, or otherdisclosure material, in whole or in part, that is said to beincorporated by reference herein is incorporated herein only to theextent that the incorporated material does not conflict with existingdefinitions, statements, or other disclosure material set forth in thisdisclosure. As such, and to the extent necessary, the disclosure asexplicitly set forth herein supersedes any conflicting materialincorporated herein by reference. Any material, or portion thereof, thatis said to be incorporated by reference herein, but which conflicts withexisting definitions, statements, or other disclosure material set forthherein will only be incorporated to the extent that no conflict arisesbetween that incorporated material and the existing disclosure material.

Versions of the devices described above may have application inconventional medical treatments and procedures conducted by a medicalprofessional, as well as application in robotic-assisted medicaltreatments and procedures. By way of example only, various teachingsherein may be readily incorporated into a robotic surgical system suchas the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, Calif.Similarly, those of ordinary skill in the art will recognize thatvarious teachings herein may be readily combined with various teachingsof U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool withUltrasound Cauterizing and Cutting Instrument,” published Aug. 31, 2004,the disclosure of which is incorporated by reference herein.

Versions described above may be designed to be disposed of after asingle use, or they can be designed to be used multiple times. Versionsmay, in either or both cases, be reconditioned for reuse after at leastone use. Reconditioning may include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, someversions of the device may be disassembled, and any number of theparticular pieces or parts of the device may be selectively replaced orremoved in any combination. Upon cleaning and/or replacement ofparticular parts, some versions of the device may be reassembled forsubsequent use either at a reconditioning facility, or by an operatorimmediately prior to a procedure. Those skilled in the art willappreciate that reconditioning of a device may utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

By way of example only, versions described herein may be sterilizedbefore and/or after a procedure. In one sterilization technique, thedevice is placed in a closed and sealed container, such as a plastic orTYVEK bag. The container and device may then be placed in a field ofradiation that can penetrate the container, such as gamma radiation,x-rays, or high-energy electrons. The radiation may kill bacteria on thedevice and in the container. The sterilized device may then be stored inthe sterile container for later use. A device may also be sterilizedusing any other technique known in the art, including but not limited tobeta or gamma radiation, ethylene oxide, or steam.

Having shown and described various embodiments of the present invention,further adaptations of the methods and systems described herein may beaccomplished by appropriate modifications by one of ordinary skill inthe art without departing from the scope of the present invention.Several of such potential modifications have been mentioned, and otherswill be apparent to those skilled in the art. For instance, theexamples, embodiments, geometries, materials, dimensions, ratios, steps,and the like discussed above are illustrative and are not required.Accordingly, the scope of the present invention should be considered interms of the following claims and is understood not to be limited to thedetails of structure and operation shown and described in thespecification and drawings.

I/We claim:
 1. An ultrasonic instrument comprising: (a) a body; (b) anactuation assembly, wherein the actuation assembly comprises anactivation member, wherein the activation member is operable to move ina first direction to select a mode of operation; (c) a shaft assemblyextending distally from the body, wherein the shaft assembly defines alongitudinal axis, wherein the shaft assembly comprises an acousticwaveguide; and (d) an end effector comprising an ultrasonic blade,wherein the ultrasonic blade is in acoustic communication with theacoustic waveguide, wherein the activation member is operable to move ina second direction to activate the end effector in a mode of operationselected by movement of the activation member in the first direction. 2.The ultrasonic instrument of claim 1, wherein the end effector isconfigured to be activated in a first activation mode in response tomovement of the activation member in the second direction when theactivation member is in a first position, wherein the end effector isconfigured to be activated in a second activation mode in response tomovement of the activation member in the second direction when theactivation member is in a second position.
 3. The ultrasonic instrumentof claim 1, wherein the activation member comprises a rotatable wheel,wherein the rotatable wheel is configured to rotate about a rotationalaxis that is perpendicular to the longitudinal axis of the shaftassembly to select a mode of operation, wherein the second direction istransverse to the rotational axis.
 4. The ultrasonic instrument of claim1, wherein the activation member comprises a button, wherein the buttonis movable laterally in the first direction.
 5. The ultrasonicinstrument of claim 4, wherein the button is pivotable laterally in thefirst direction about a pivot axis that is perpendicular to thelongitudinal axis of the shaft assembly.
 6. The ultrasonic instrument ofclaim 5, wherein the pivotable button is configured to pivot in thefirst direction between a first position, a second position, and a thirdposition, wherein the second position is between the first and thirdpositions.
 7. The ultrasonic instrument of claim 6, wherein thepivotable button is resiliently biased to the second position.
 8. Theultrasonic instrument of claim 6, wherein the pivotable button isinoperable to activate the end effector when the pivotable button is inthe second position.
 9. The ultrasonic instrument of claim 1, whereinthe activation member is configured to select between a first mode ofoperation and a second mode of operation, wherein the end effector isconfigured to apply ultrasonic energy to tissue at a first power levelin the first mode of operation, wherein the activation member isconfigured to apply ultrasonic energy to tissue at a second power levelin the second mode of operation.
 10. The ultrasonic instrument of claim1, wherein the activation member is configured to select between a firstmode of operation and a second mode of operation, wherein the endeffector is configured to apply ultrasonic energy to tissue in the firstmode of operation, wherein the activation member is configured to applyRF energy to tissue in the second mode of operation.
 11. The ultrasonicinstrument of claim 1, wherein the body is configured to be grasped by ahand of an operator.
 12. The ultrasonic instrument of claim 11, furthercomprising a sensor, wherein the sensor is configured to sense whetherthe body is grasped by a right hand or a left hand of an operator. 13.The ultrasonic instrument of claim 12, further comprising a controllerin communication with the sensor, wherein the actuation assembly furthercomprises a first lateral actuator and a second lateral actuator,wherein the first and second lateral actuators are on opposite lateralsides of the body, wherein the controller is operable to varyfunctionality of the first and second lateral actuators based on datafrom the sensor indicating whether the body is grasped by a right handor a left hand of an operator.
 14. The ultrasonic instrument of claim13, wherein the activation member is operable to activate the endeffector to apply ultrasonic energy to tissue via the ultrasonic blade,wherein the first lateral actuator or the second lateral actuator isoperable to activate the end effector to apply RF electrosurgical energyto tissue.
 15. The ultrasonic instrument of claim 1, further comprisinga visual indicator on the body, wherein the visual indicator isconfigured to provide visual feedback indicating a mode of operationselected through movement of the activation member in the firstdirection.
 16. An ultrasonic instrument comprising: (a) a body; (b) abutton assembly, wherein the button assembly comprises: (i) a firstbutton member defining an opening and a distal face, and (ii) a secondbutton member positioned within the opening of the first button member;(c) a shaft assembly extending distally from the body; and (d) an endeffector positioned at a distal end of the shaft assembly, wherein theend effector is operable to apply one or both of ultrasonic energy or RFelectrosurgical energy to tissue; wherein the first button member isconfigured to translate through a first range of motion relative to thebody to activate the end effector in a first mode of operation, whereinthe second button member is configured to remain stationary relative tothe body as the first button member translates through the first rangeof motion; wherein the first button member is configured to translatethrough a second range of motion relative to the body to activate theend effector in a second mode of operation, wherein the second buttonmember is configured to translate with the first button member relativeto the body as the first button member translates through the secondrange of motion.
 17. The ultrasonic instrument of claim 16, wherein thesecond button member has a distal end, wherein the distal end isrecessed within the opening and relative to the distal face of the firstbutton member until the first button member translates through the firstrange of motion.
 18. The ultrasonic instrument of claim 16, wherein thefirst button member has a proximal flange, wherein the second buttonmember has a proximal flange, wherein the proximal flange of the firstbutton member is configured to engage the proximal flange of the secondbutton member upon completion of the first range of motion by the firstbutton member.
 19. An ultrasonic instrument comprising: (a) a body; (b)an actuation assembly, wherein the actuation assembly comprises anactivation member, wherein the activation member is operable to movealong a range of motion relative to the body; (c) a shaft assemblyextending distally from the body, wherein the shaft assembly defines alongitudinal axis, wherein the shaft assembly comprises an acousticwaveguide; and (d) an end effector comprising an ultrasonic blade,wherein the ultrasonic blade is in acoustic communication with theacoustic waveguide, wherein the activation member is operable toactivate the ultrasonic blade at a progressively increasing power levelalong a continuous range of power levels based on the position of theactivation member along the range of motion relative to the body. 20.The ultrasonic instrument of claim 19, wherein the activation member isoperable to activate the ultrasonic blade at a progressively increasingpower level along a continuous range of power levels that isproportional to the position of the activation member along the range ofmotion relative to the body.